Cave Consulting Group (“CCGroup”) Receives Patent on MedMarkers™ to Support Healthcare Provider Efficiency Scores
CCGroup is pleased to announce that the United States Patent and Trademark Office has issued Patent No. 8,301,464 on its CCGroup BullsEye™ methods of statistical analysis. The CCGroup BullsEye™ system targets those medical care services most associated with provider overall efficiency scores and provider medical condition-specific efficiency scores.
“[U.S.] Patent No. 8,301,464 comes on the heels of [U.S.] Patent No. 7,739,126 which CCGroup received in June 2010 on our [‘Marketbasket’ approach to provider efficiency measurement],” stated Dr. Douglas G. Cave, President of CCGroup. The 7,739,126 patent protects CCGroup’s novel approach to analyzing provider efficiency‘using a predefined set of medical conditions for a specialty type’ and calculating weighted episode of care statistics across those predefined medical conditions. The provider efficiency analytics and statistics allow our health plan and physician group clients to obtain accurate and reliable efficiency scores, something that has been very elusive to date.
The newly-issued U.S. Patent No. 8,301,464 is directed to the CCGroup BullsEye™ statistical analysis methodologies and specifically protects CCGroup’s MedMarkers™ technology, ‘which correlates medical care procedures and services to a provider’s overall efficiency score and/or medical condition efficiency score.’
The invention in Patent No. 8,301,464 automates the process for targeting MedMarkers™. That is, the CCGroup invention provides the software, methods, and algorithms needed for analysts and clinicians to observe the associations of procedures and services to the efficiency scores by specialty type. This automation process saves information technology (IT) resources, statistician, analyst, and clinical resources.
John Rootenberg, M.D., SVP of Clinical Strategy for CCGroup, affirmed that MedMarkers™ are identified at the specialty-specific level. “One of the main MedMarkers™ associated with the overall efficiency score for invasive cardiologists is left heart catheterizations,” stated Dr. Rootenberg. “In treating a predefined set of cardiac-related medical conditions, those invasive cardiologists that perform more left heart catheterizations (than their peer group) tend to have a correlated inefficient score.”
Dr. Rootenberg continued, “CCGroup is the first company to identify the MedMarkers™ correlated to each specialty type’s overall efficiency score. The MedMarkers™ hold up amazingly well across geographic regions and covered population groups, such as Medicare Advantage, Medicaid, and commercial HMO enrollees.”
The reason CCGroup has identified the MedMarkers™ before any other organization is the innovation of the original Patent No. 7,739,126 that focuses on a predefined set of medical conditions by specialty type. “Our Patent No. 7,739,126 prevents any other organization from formulating overall efficiency scores using a predefined set of medical conditions,” stated Dr. Cave. “In effect, you need to examine a constant blend of predefined, prevalent, lower resource intensive episodes in order to find the MedMarkers™ by specialty type. Since no other organization is allowed to use CCGroup’s patented approach to provider efficiency evaluation, they lack the ability to effectively identify and evaluate MedMarkers™.”
The innovation presented in Patent No. 8,301,464 also covers the identification of MedMarkers™ at the medical condition level. “CCGroup has identified the key MedMarkers™ for most prevalent medical conditions by specialty type,” declared Dr. Rootenberg. “For instance, the MedMarker™ for gastroenterologists treating routine gastroesophageal reflux disease (GERD or heartburn) is upper gastrointestinal endoscopy. The correlation is off-the-charts for upper gastrointestinal endoscopy and gastroenterologists’ GERD efficiency scores. Efficiently scored gastroenterologists generally perform no more than 3 upper gastrointestinal endoscopies per 10 episodes of routine GERD. Inefficiently scored gastroenterologists perform more than 5 upper gastrointestinal endoscopies per 10 episodes of routine GERD.”
After establishing baseline MedMarker™ practice pattern results, health plans, physician groups, and Federal and State governments can focus on reducing practice variability. This improves patient quality of care and cost of care. “CCGroup has built a large national comparative database of medical condition-specific MedMarker™ results,” declared Dr. Cave. “We use this MedMarker™ comparative database to develop important protocol practice ranges for each MedMarker™ by medical condition. Our clients share the MedMarker™ protocol practice ranges with practicing physicians to help reduce unintended medical condition-specific, practice variations.”
About Cave Consulting Group
Cave Consulting Group, Inc. is a software and consulting firm located in San Mateo, California. The company is focused on improving the efficiency (cost-of-care) and effectiveness (quality-of-care) of the healthcare delivery system. Senior management of CCGroup has assessed the performance of physicians and hospitals for over 23 years for health plans, HMOs, physician groups, health systems, TPAs, and employers.
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